Up-to Date Review And Case Report

Oral nodular fasciitis – A case report with a diagnostic schema

¹ Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
² Department of Pathology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
³ Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnakata, India
⁴ Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India

^* Correspondence: monica.charlotte@manipal.edu

Received: 8 December 2018
Accepted: 18 March 2019

Abstract

Introduction: The spectrum of myofibroblastic lesions of the oral cavity ranges from reactive to benign to malignant lesions with overlapping histopathologic and immunohistologic characteristics posing a diagnostic dilemma. Observation: A 30-year-old male presented with a spontaneous swelling over the right lower buccal gingiva giving a clinical suspicion of a benign mesenchymal tumor. The lesion presented with a varied biphasic microscopic appearance that posed as a challenge for diagnosis. Commentaries: The incisional biopsy of the lesion showed a highly collagenous stroma with spindle-shaped cells, while the excision biopsy revealed myxoid and hyalinized stroma. A panel of markers comprising of SMA (smooth muscle actin). CD-34, β-Catenin, and Alcian blue stain was employed to arrive at a diagnosis. Conclusion: Most myofibroblastic lesions present with diverse histological appearance which warrants a thorough assessment of the cellular and stromal components for an accurate diagnosis.